Typical depot antipsychotic
Haloperidol decanoate
Brand names: Haldol decanoate
Adult dose
Dose: Test 25mg IM; usual maintenance 50–300mg every 4 weeks (max 300mg every 4 weeks)
Route: Deep IM
Frequency: every 4 weeks
Clinical pearls
- Maintenance schizophrenia where adherence is the limiting factor
- ECG before initiation; baseline metabolic screen
Contraindications
- CNS depression
- Comatose states
- Parkinson's disease/dementia with Lewy bodies
- Recent MI
- Long QT/torsades risk
Side effects
- EPSE
- Tardive dyskinesia
- NMS
- QT prolongation
- Hyperprolactinaemia
- Sedation
Interactions
- QT-prolonging drugs
- Lithium (neurotoxicity)
- Levodopa antagonism
- CNS depressants
Monitoring
- ECG
- Prolactin
- Glucose/lipids
- Weight
- BP
Reference: BNF; Maudsley Prescribing Guidelines; https://bnf.nice.org.uk/drugs/haloperidol-decanoate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF